Pulmonology 4

A patient presents with chest pains that are worse with moving and deep breaths, you suspect pleurisy. How would you distinguish the rub of pleurisy from the rub heard in pericarditis?

A 25-year-old healthy patient cleaning out an old storage unit that has been untouched in the dry desert air for 10 years. While sweeping he inhaled a lot of dust. He felt fine for a few days but then became acutely short of breath and required intubation in the Emergency room.  His chest X-ray shows bilateral congestive changes.  What do you suspect caused the acute respiratory distress?

Which of the following is the drug of choice for Mycoplasma pneumonia infection in a eight year old child?

Which of the following lung function test results would be expected in a person suffering from COPD?

Immediately after a diagnostic thoracentesis in the right chest, a 56-year-old man has acute dyspnea. Examination shows reduced thoracic expansion, hyperresonance, and decreased breath sounds on the affected side. Which of the following is the most likely diagnosis?

A 23-year-old motorcyclist, in excellent health, is admitted to the hospital after a cycling accident in which he lost consciousness due to blunt head trauma. On the third hospital day, the patient develops a temperature of 103 degrees F and he is noted to be confused. Exam further reveals a new cranial nerve IV palsy and stiff neck. Chest X-ray demonstrates a right middle lobe infiltrate. Cerebrospinal fluid gram stain reveals gram positive cocci. Diagnosis:

While sitting in a chair, a tall, thin 20-year-old athletic man suddenly notes the onset of sharp right upper anterior chest pain associated with mild dyspnea. The pain persists for 8 hours so he comes to the office for evaluation. There is no associated fever, cough, or hemoptysis; no history chest trauma. Physical exam is normal except for respiratory rate of 26/min. Which one of the following is the most likely physical exam finding in this patient?

A mother brings in her six-month-old infant because “he has been wheezing for the past couple of days”. He is noted to have a low-grade fever, tachypnea, and mild expiratory wheezes. His nostrils are mildly congested with clear nasal drainage, the throat is pink without exudates, and the TM’s are pearly gray without fluid levels and the cone of light is intact bilaterally. Which of the following tests would you order to confirm your assessment?

A 65-year-old Caucasian male presents with a progressive, constant and severe history of dyspnea for the last few weeks. There is a 40 pack-year history of smoking. Physical examination reveals a thin, wasted-appearing gentleman. No cyanosis present. The AP chest diameter is increased. Percussion note over the lung fields is hyperresonant. Laboratory studies reveal increased total lung capacity and absent respiratory acidosis. This is a presentation of which of the following?

When prescribing Isoniazid and Rifampin, patients must be monitored closely for which one of the following?

Which of the following is consistent with a diagnosis of a moderate asthma attack?

Which of the following is not a characteristic of obstructive sleep apnea?

The goals of treatment for asthma are all of the following except:

Clinical features of pulmonary hypertension include all of the following except:

A 38-year-old African American female presents with a complaint of progressively worsening fatigue and dyspnea over the past several months. She also reports vague arthralgias and tender lesions on the front of her legs that will last for several weeks and then resolve—but they are recurring. Her pulmonary examination is unremarkable. There is a 3 cm erythematous tender nodule on the anterior shin. Chest x-ray reveals bilateral hilar lymphadenopathy. Pulmonary function tests show a restrictive pattern. Laboratory results show hypercalcemia. Which of the following is the most likely diagnosis?

Clinical features of sleep apnea syndrome include all of the following except?

A chest x-ray of a patient with pulmonary hypertension might disclose all the following except:

Which of the following statements is true of sudden infant death syndrome (SIDS)?

Which of the following is a risk factor for development of spontaneous pneumothorax?

Select the mechanism of action of cephalexin.

A 44-year-old nurse presents with an eight-day history of cough, sweats, fever, chest pain, and chills. Physical examination reveals altered breath sounds, crackles, and bronchial breath sounds. Culture of respiratory secretions was positive for Pseudomonas aeruginosa bacteria. You diagnose this patient with hospital-acquired pneumonia. Which of the following treatment options would you suggest?

A 50-year-old female presents with dull pain, swelling, redness, and tenderness of the left leg. Blood work reveals a d-dimer level of 750 ng/dL. Based on the patient’s presentation, which of the following diagnostic exams would you perform next?

An 18-month-old infant presents with runny nose, sneezing, wheezing, and low-grade fever. Physical examination reveals nasal flaring, tachypnea, and retractions indicating respiratory distress. CBC was normal and chest X-ray was normal. Nasal washing was positive for respiratory syncytial virus. You diagnose this child with bronchiolitis. Which medication would you prescribe to treat this condition?

A 62-year-old obese female with an iodine allergy presents with lower leg erythema, swelling, and tenderness. She also complains of shortness of breath and chest pain occurring within the past 24 hours. Blood work reveals a d-dimer level of 800 ng/dL. Based on the patient’s presentation, which of the following diagnostic exams would you perform next?

An otherwise healthy, 27-year-old male presents with non-productive cough, low-grade fever, fatigue, and muscle aches. Sputum culture was positive for Mycoplasma pneumoniae. Based on the patient’s presentation and sputum culture, which of the following is the most appropriate diagnosis?

Which of the following medications is indicated for maintenance therapy of chronic obstructive pulmonary disease?

A 36-year-old male presents with non-productive cough, shortness of breath, fever, and substernal discomfort. Auscultation of the chest reveals expiratory rhonchi. Chest X-ray is normal. Based on the patient’s presentation, physical examination, and test results, which of the following is the most appropriate diagnosis?

Which of the following medications is indicated for maintenance therapy of mild persistent asthma?

Which of the following medications is indicated to reduce systemic arterial pressure for patients who have been diagnosed with pulmonary hypertension?

A 24-year-old female presents with a seven-day history of cough, purulent sputum, shortness of breath, chest pain, fever, and sweats. Auscultation of the chest reveals altered breath sounds with crackles, dullness to percussion, and bronchial breath sounds over an area of consolidation. Chest X-ray was performed, which reveals bilateral pleural consolidations. Based on patient symptoms and physical examination, which of the following is the proper diagnosis?